Chennai, July 28 -- Highlights:
* Insomnia rates among girls triple at puberty compared to boys
* Women sleep slightly longer but still report poorer sleep quality
* Social, hormonal, and //psychological factors combine to disrupt women's sleep Insomnia is more commonly reported by girls and women than by boys and men, a disparity beginning that begins around puberty and persists throughout the lifespan .
A systematic review published in the Journal of Sleep Research highlighted that girls face a higher risk of insomnia starting as early as ages 11 to 12 . This gender gap is maintained due to various biological, psychological, social, and environmental influences ( ref1 ).
Hormonal Changes and Sleep Onset in Adolescence Fluctuating levels of estradiol and progesterone were found to significantly affect sleep among girls and women. During puberty, a time marked by hormonal surges, adolescent girls were found to be three times more likely to suffer from insomnia compared to boys of the same age. Similarly, sleep disturbances during the menstrual cycle , especially in the luteal phase when hormonal levels fluctuate, are linked to increases in core body temperature and disrupted rest.
In contrast, sleep patterns in males are influenced by testosterone, which peaks at the onset of rapid eye movement sleep. As men age, starting from their early 30s, testosterone levels gradually decline by 1% to 2% each year, leading to reduced rapid eye movement sleep and difficulty staying asleep. Interestingly, objective sleep data reveals that despite reporting more insomnia, women tend to sleep slightly longer and have more deep sleep than men , suggesting that subjective and physiological experiences may not always align.
Reproductive Milestones and Sleep Quality
Three key phases in women's lives- puberty, pregnancy, and menopause, are associated to spikes in insomnia rates . Hormonal imbalances and shifts during these times contribute to disrupted sleep. Particularly during perimenopause, falling estrogen levels are linked to increased night-time awakenings and difficulty falling back asleep , often around early morning hours.
Women also face higher risks of certain health conditions like iron deficiency and thyroid disorders, both of which are associated with fatigue and fragmented sleep . These health concerns are especially common during the reproductive years when women often manage multiple life demands, which may exacerbate their vulnerability to poor sleep quality.
Psychological Vulnerability and Emotional Patterns
Insomnia is closely linked to psychological traits more prevalent in women, such as cognitive hyperarousal, perfectionism, neuroticism, health-related anxiety, and low self-esteem-all recognized risk factors for chronic sleep disturbances.
Furthermore, women are at higher risk for depression, anxiety, and trauma-related disorders , all of which are tied to poorer sleep. Rumination and persistent worry are cognitive patterns more commonly reported by women, further intensifying sleep challenges. Women are also more frequently prescribed antidepressants, which can interfere with sleep cycles and lead to either sedation or sleep disruption, depending on the medication.
Social Responsibilities and Sleep Pressure
Beyond biological and psychological contributors, societal expectations place additional strain on women's ability to rest. Emotional labor and caregiving tasks are still disproportionately handled by women, and data shows they average nine more hours of unpaid work per week compared to men . This imbalance limits opportunities for daytime rest, increasing reliance on nighttime sleep for recovery and placing added pressure on achieving uninterrupted, restorative rest.
Even when women manage to get enough sleep by objective standards, many still report waking up unrefreshed. Their fatigue can often reflect more than just poor sleep, it can indicate hidden health concerns, emotional exhaustion, or societal pressure to meet unrealistic standards of performance and care.
Insomnia Persistence and Research Gaps
Factors such as persistent worry, dysfunctional beliefs about sleep, and heightened physical tension were found to perpetuate insomnia over time. Although these contributors apply to all genders, they appear more pronounced among women due to their increased exposure to stress and internalized expectations.
A critical gap in the literature is the lack of comprehensive data on sleep disorders in gender-diverse populations, including transgender individuals. Current research does not yet fully explain how gender-affirming hormone therapy affects sleep architecture, leaving significant knowledge gaps about sleep health across the gender spectrum.
Gendered Sleep Experience Beyond Duration
Objective assessments, such as large-scale wearable tracker studies and polysomnography data, show that women tend to sleep about 19 to 29 minutes longer than men and experience more deep sleep .
However, these measurable advantages in sleep quantity and depth contrast with women's subjective reports of sleep dissatisfaction. This well-documented mismatch underscores the complexity of sleep as an experience shaped not only by biology but also by psychological and contextual factors.
Studies that isolate sleep from mental health conditions, hormonal changes, medications, or alcohol use often fail to capture the lived experiences of many women. This discrepancy shows that sleep is not just a biological process but also shaped by mental states, health, and societal roles-especially for women juggling multiple responsibilities during key life stages.
To sum up, although women may sleep slightly longer and more deeply than men in controlled settings, they face greater challenges in achieving restful sleep due to hormonal fluctuations, psychological vulnerability, health conditions, and unequal societal burdens. These interwoven factors contribute to a consistently higher prevalence of insomnia among women and girls across the lifespan. Reference:
* Insomnia Disorder: Gender Issues Over the Lifespan - (https://pubmed.ncbi.nlm.nih.gov/40461101/)
Source-Medindia